NPIMap

Organization Active NPI

Santa Rosa Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
National Provider Identifier
1245739697
Registry record updated Feb 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SANTA ROSA COMMUNITY HEALTH CENTER
Practice address
3883 Airway Dr Ste 202
Santa Rosa, CA 95403-1671
Phone
(707) 583-8748
Fax
(707) 236-6919
NPI assigned
Feb 12, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Harold Brockman
Title
Cfo
Phone
(707) 583-8839

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

3883 Airway Dr Ste 202
Santa Rosa, CA 95403-1671

Mailing address

3569 Round Barn Cir
Santa Rosa, CA 95403-5781
Phone (707) 303-3600

Other names 1

  • Airway Campus Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Santa Rosa Community Health Center16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518393600000",
    "number": "1245739697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3569 ROUND BARN CIR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954035781",
            "telephone_number": "707-303-3600",
            "fax_number": "707-396-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3883 AIRWAY DR STE 202",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031671",
            "telephone_number": "707-583-8748",
            "fax_number": "707-236-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA ROSA COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-12",
        "last_updated": "2018-02-12",
        "status": "A",
        "authorized_official_last_name": "BROCKMAN",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "707-583-8839"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Airway Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.